Abstract:Objective To explore the application value of auramine O fluorescent staining method in frozen sections of lung tissues.Methods A total of 86 intraoperative frozen sections of lung tissues with suspected Mycobacterium tuber-culosis infection in author's hospital from January 2022 to December 2023 were selected for auramine O fluorescent stai-ning method,the paraffin sections were stained with auramine O fluorescent staining method and carbol fuchsin staining method,the results of sputum smear bacterial culture were used as the gold standard,and the results of the 3 staining methods and the gold standard were compared.Results The auramine O fluorescent staining method in intraoperative frozen sections was in excellent agreement with the gold standard(κ=0.842),and auramine O fluorescent staining meth-od in postoperative paraffin sections was in moderate agreement with the gold standard(κ=0.563);the carbol fuchsin staining method of postoperative paraffin sections were moderately consistent with the gold standard(κ=0.524).The ac-curacy,sensitivity and specificity of intraoperative auramine O fluorescent staining method in frozen sections were 93.02％,83.33％and 98.21％,respectively,which were all higher than auramine O fluorescent staining method in post-operative paraffin sections(the accuracy,sensitivity and specificity were 81.40％,60.00％and 92.86％,respectively).The accuracy,sensitivity and specificity of carbol fuchsin staining method in postoperative paraffin sections were 80.23％,53.33％and 94.68％,respectively.Conclusion The auramine O fluorescent staining method of intraoperative frozen sections are reliable,convenient and efficient,which has application value in the auxiliary diagnosis of pulmonary tuberculosis infection during operation.

Abstract:Objective To analyze the risk factors for early neurological deterioration in patients with moderate trau-matic brain injury(mTBI).Methods A retrospective analysis was conducted on the clinical data of 479 patients with mTBI admitted to the authors' hospital from January 1,2015 to December 31,2020.Based on whether the Glasgow coma scale(GCS)score decreased by≥2 within 24 h or emergency surgery was performed,patients were categorized into neu-rological deterioration group(n=45)and non-deterioration group(n=434).The baseline clinical characteristics of the patients between two groups were compared,and multivariate Logistic regression analysis was performed to identify inde-pendent risk factors for early neurological deterioration in patients with mTBI.Results Among the 479 patients with mTBI,45 experienced neurological deterioration,yielding an incidence rate of 9.39％.Univariate analysis identified oral aspirin use,GCS,injury severity score(ISS),fibrin degradation products,platelet count,D-dimer,aspartate amin-otransferase and midline shift as risk factors for rapid neurological deterioration,while multivariate Logistic regression analysis revealed that oral aspirin[odds ratio(OR)=2.882,95％confidence interval(CI):1.045-7.954],platelet count(OR=0.994,95％CI:0.988-1.000)and GCS(OR=0.727,95％CI:0.535-0.986)were independent risk fac-tors for early neurological deterioration in mTBI patients(P＜0.05).Conclusion Patients with mTBI should be alert to the occurrence of early neurological deterioration.oral aspirin,platelet count and GCS are independent risk factors for early neurological deterioration of mTBI.

Abstract:Objective To analyze the current status of electronic health literacy and its influencing factors among grassroots officers and soldiers,so as to provide a basis for improving their electronic health literacy.Methods A total of 2 334 grassroots officers and soldiers were selected as the research subjects from August to October 2024,the electronic health literacy scale(eHEALS)was used to investigate their current status of electronic health literacy,according to whether the eHEALS score exceeded 32 points,they were divided into qualified group(n=1 208)and unqualified group(n=1 118),and Logistic regression was used to analyze the influencing factors of qualified ehealth literacy of grassroots officers and soldiers.Results A total of 2 334 questionnaires and eHEALS were distributed,and 2 326 were effectively recovered,with an effective rate of 99.66％.A total of 1 208 officers and soldiers passed the eHEALS,with a passing rate of 51.93％;the average score of eHEALS health items was(3.63±0.91),and the average scores of the ability to apply,judge and make decisions on online health information and services were(3.61±0.91),(3.65±0.92)and(3.63±0.90),respectively.Military service length of 5-10 years and＞10 years[odds ratio(OR)=0.395,95％confidence interval(CI):0.247-0.633;OR=0.341,95％CI:0.226-0.515)],education level of senior high school and junior college(OR=0.461,95％CI:0.341-0.624;OR=0.660,95％CI:0.506-0.860),frequency of using health mobile apps≥5 times per month(OR=1.565,95％CI:1.395-1.807),considering online information almost correct(OR=1.717,95％CI:1.397-2.112),high credibility of online information(OR=1.597,95％CI:1.470-1.759),and occa-sionally checking or paying attention to health information every day(OR=1.832,95％CI:1.389-2.415;OR=3.615,95％CI:2.418-5.407)were the influencing fac-tors for qualified electronic health literacy level of the sur-veyed officers and soldiers(P＜0.05).Conclusion The electronic health literacy level of grass-roots officers and soldiers is insufficient,and there is a lot of room for improvement,more attention should be paid to the electronic health literacy level of grassroots officers and soldiers.

Abstract:Objective To investigate the protective effects of Xiaohuang Qudan Decoction on liver fibrosis and ex-plore its potential mechanisms.Methods A total of 18 specific pathogen free(SPF)-grade mice were randomly divided into control group,model group,high-dose traditional Chinese medicine group,medium-dose traditional Chinese medicine group,low-dose traditional Chinese medicine group and colchicine group(positive control),with 3 mice in each.Except for the control group,all the other groups were intraperitoneally injected with 10％CCl4 olive oil solution to establish mouse liver fibrosis model.The contents of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)and hydroxyproline(HYP)in serum were meas-ured;hematoxylin-eosin(HE)staining and Masson staining were used to observe liver pathological morphology and colla-gen deposition,while oil red O staining was used to observe lipid deposition in liver tissues;enzyme-linked immunosor-bent assay(ELISA)was used to detect levels of hyaluronic acid(HA),laminin(LN),type Ⅲ procollagen(PC Ⅲ)and type Ⅳ collagen(Col Ⅳ);immunohistochemistry was used to observe the levels of smooth muscle actin alpha(α-SMA),type Ⅰ collagen(ColⅠ)and transforming growth factor beta 1(TGF-β1)in liver tissues;real-time quantitative polymer-ase chain reaction(qPCR)was used to detect the gene expression levels of protein P62,autophagy-related gene Beclin 1,microtubule-associated protein light chain 3 Ⅱ/Ⅰ(LC3-Ⅱ/Ⅰ),AMP-activated protein kinase(AMPK),mammalian target of rapamycin(mTOR)and Unc-5 1 like autophagy activating kinase 1(ULK1)gene expression in liver tissues;Western blot was used to detect the protein expression levels of P62,Beclin-1,LC3-Ⅱ/Ⅰ,p-AMPK,AMPK,p-mTOR,mTOR and ULK1 in liver tissues.Results Compared with the control group,the contents of AST,ALT,HYP,LN,HA,PC Ⅲ and Col Ⅳ in the model group,low-dose Chinese medicine group,medium-dose Chinese medicine group,high-dose Chinese medicine group and the colchicine group significantly increased(P＜0.05).The expression lev-els of Beclin-1 and LC3-Ⅱ/Ⅰ proteins increased(P＜0.05),the expression levels of Beclin-1 and LC3 genes increased(P＜0.01),the expression levels of P62 protein and gene decreased(P＜0.01),the ratio of p-AMPK/AMPK and ULK1 protein and the expression of AMPK and ULK1 gene significantly increased(P＜0.05),while the expression of p-mTOR/mTOR protein and mTOR gene significantly decreased(P＜0.05).Compared with the model group,the con-tents of AST,ALT,HYP,LN,HA,PC Ⅲ and Col Ⅳ in the the low-dose Chinese medicine group,high-dose Chinese medicine group and the colchicine group decreased(P＜0.05),and the inflammatory infiltration and collagen deposition in the liver were significantly improved,and the liver fat deposition was improved;the protein expression of Beclin-1 and LC3-Ⅱ/Ⅰ decreased(P＜0.05),and the gene expression of Beclin-1 and LC3 decreased(P＜0.05),and the protein and gene expression of P62 increased(P＜0.05);the protein expression of α-SMA,Col Ⅰ and TGF-β1 significantly de-creased;the expression of p-AMPK/AMPK,UKL1 protein and AMPK gene significantly decreased(P＜0.05),and the expression of p-mTOR/mTOR protein and mTOR gene significantly increased(P＜0.05).Conclusion Xiaohuang Qudan Decoction can alleviate liver fibrosis to some extent,and its mechanism may involve regulating the AMPK/mTOR/ULK1 signaling pathway,reducing hepatic cell autophagy and thereby delaying the progression of liver fibrosis.

Abstract:Objective To construct a multi-dimensional pre-rehabilitation program for lumbar military training inju-ry(MTI)patients and explore its application effect.Methods Guided by shared decision-making theory,a multi-dimensional prehabilitation program with evidence from the literature review and semi-structured interviews was developed,after two rounds of expert consultation,the final program was determined.According to the order of admission,60 patients with lumbar MTI who were hospitalized in the author's hospital from June to August 2024 were selected as the control group by convenience sampling method and received routine perioperative nursing;a total of 60 patients with lumbar MTI hospitalized from September 2024 to November 2024 were selected as the experimental group,and were intervened according to the multi-dimensional pre-rehabilitation program on the basis of routine perioperative nursing.The scientificness,practicability and application effect of multi-dimensional pre-rehabilitation program were evaluated.Results The expert positive coefficients of the two rounds of expert letter inquir-ies were all 100.00％,the expert authority coefficients were 0.926 and 0.956,the variation coefficients were 0.162 and 0.127,and the Kendall harmony coefficients were 0.339 and 0.205,respectively;the content of the final scheme included 5 first-level items,18 second-level items and 57 third-level items.The Oswestry disability index(ODI),15-item quality of recovery(QOR-15),generalized anxiety disorder scale-7 items(GAD-7),patient health questionnaire-9 items(PHQ-9),the first time to get out of bed after operation,average length of hospital stay and hospitalization satisfaction of patients in the experimental group were better than those of the control group(all P＜0.05).Conclusion The preoperative multi-di-mensional pre-rehabilitation scheme based on the shared decision theory is scientific and reasonable,with good practicabil-ity and popularization,which improves and enrichments the connotation of rapid rehabilitation of lumbar MTI,and provides a reference for further improving the medical support ability of military hospitals at both peacetime and wartime.

Abstract:Objective To screen apoptosis-related genes associated with postoperative disease progression of esophageal cancer based on the cancer genome atlas(TC-GA)database,construct a prediction model for postoperative disease progression of esophageal cancer,and validate the value of the predictive model.Methods Gene expression data of esophageal cancer tumor tissues and normal tissues,as well as postoperative disease progression status of patients,were obtained from TCGA database,and apoptosis-related genes with differential expression of esophageal cancer tumor tissues and normal tissues were screened out;the least abso-lute shrinkage and selection operator(LASSO)regression and Cox regression were used to screen key apoptosis-related genes associated with postoperative progression of esophageal cancer,and the disease progression risk model was con-structed,the validity and accuracy of the model were analyzed by Kaplan-Meier survival curve,risk curve and receiver op-erating characteristic(ROC)curve.Finally,47 esophageal cancer patients from the author's hospital were enrolled for validation.Results A total of 81 esophageal cancer tissue samples and 26 normal esophageal tissues were obtained from TCGA database,and 33 differentially expressed apoptosis-related genes in esophageal cancer tumor tissues and normal esophageal tissues were obtained.Twenty-nine apoptosis-related genes related to postoperative disease progression in pa-tients with esophageal cancer were screened out by Cox regression analysis,including[Caspase-1(CASP1),CASP3,CASP4,CASP5,CASP6,CASP8,CASP9,Gasdermin A(GSDMA),GSDMB,GSDMC,GSDMD,GSDME,interleukin 18(IL-18),IL-1B,NLR family CARD domain-containing protein 4(NLRC4),NLR family pyrin domain-containing 1(NLRP1),NLRP2,NLRP3,NLRP7,nucleotide-binding oligomerization domain-containing protein 1(NOD1),phospho-lipase C gamma 1(PLCG1),protein kinase cAMP-activated catalytic subunit alpha(PRKACA),PYD and CARD do-main-containing protein(PYCARD),SR-related CTD-associated factor 11(SCAF11),neutrophil elastase(ELANE),IL-6,NLRP6,tumor necrosis factor(TNF),glutathione peroxidase 4(GPX4)];15 apoptosis-related genes most strongly as-sociated with postoperative disease progression in esophageal cancer patients were screened out using LASSO regression,including CASP3,GSDMB,GSDMC,NLRC4,NLRP3,NLRP7,NOD1,PLCG1,PRKACA,SCAF11,ELANE,IL-6,NLRP6,TNF and GPX4,among these,11 genes(IL-6,CASP3,GSDMB,GSDMC,NLRC4,NLRP3,NLRP7,NOD1,PLCG1,PRKACA and SCAF11)were identified as risk factors,while 4 genes(ELANE,NLRP6,TNF,GPX4)were classified as protective factors;Kaplan-Meier curve analysis revealed that the overall survival time of patients in the high-risk group was significantly shorter than that in the low-risk group(P＜0.05);the ROC curve analysis demonstra-ted that the area under the curve(AUC)for predicting postoperative disease progression risk in esophageal cancer was 0.773(95％CI:0.633-0.879);risk curve analysis indicated that,as the risk score increased,the survival time of pa-tients in the high-risk group decreased more significantly compared to the low-risk group,and the number of death also in-creased.Further validation of the model's predictive efficacy was performed using 47 esophageal cancer patients,and the results showed the AUC of 0.754(95％CI:0.611-0.864).Conclusion The risk prediction model for postoperative dis-ease progression of esophageal cancer constructed based on apoptosis-related genes can effectively predict the risk of post-operative disease progression in esophageal cancer patients,and may be used in clinical practice for identifying high-risk patients with postoperative disease progression of esophageal cancer and guiding their treatment.

Abstract:Objective To identify risk factors for high-altitude de-acclimatization reaction and to develop the risk-prediction model to support targeted prevention.Methods In August 2022,1 544 individuals who descended from the Ti-betan plateau(≥3 000 m)to plain were recruited by cluster sampling,the data were collected through the questionnaire survey,and the subjects were divided into the high-altitude de-acclimatization reaction group(n=192)and the non-high-altitude de-acclimatization reaction group(n=1 352).Decision tree(DT),random forest(RF)and extreme gradient boosting(XGBoost)served as base model,Logistic regression was used to construct the Stacking ensemble learning mod-el,the receiver operating characteristic(ROC)curve area under the curve(AUC)of 4 single prediction models and Stac-king ensemble learning models were compared,and the predictive efficacy of the model was evaluated.In this study,70％of the questionnaire data of high-altitude de-acclimatization reaction were randomly divided into the training set and the re-maining 30％into the test set.According to the AUC value of the model test set,the importance of the characteristics of the variables screened by each model was weighted average,and a comprehensive importance rank-ing of the variables was obtained to find the risk factors for the occurrence of high-altitude de-acclimatization reac-tion.Results Among the 1 544 subjects,192 had high-altitude de-acclimatization reaction.The AUC values of Logistic regression,DT,RF,XGBoost and Stacking ensemble learning models in the test set were 0.757,0.601,0.788,0.793 and 0.853,respectively.DT,RF and XGBoost models comprehensively screened out the risk factors of high-altitude de-acclimatization reaction,including the number of days that had been to plateau,acute mountain sickness(AMS)of this time,family history of chronic diseases,altitude of plain residence,smoking,means of transportation back to the plain and body mass index(BMI).Conclusion Taking the way of transportation back to the plain,the number of days in the history of visiting the plateau,AMS situation of this time,the altitude of residence,smoking,family history of chronic diseases and BMI as predictors,the Stacking ensemble learning model constructed had the best comprehensive perform-ance in the test set,which was convenient for application.

Abstract:Objective To investigate the influencing factors of hyperlipidemia in patients with type 2 diabetes melli-tus(T2DM)and construct a nomogram prediction model.Methods A total of 186 T2DM patients admitted to author's hospital from March 2021 to March 2023 were enrolled,the patients were divided into T2DM group(n=90)and T2DM combined with hyperlipidemia group(n=96)based on the presence of hyperlipidemia.General clinical data of patients be-tween two groups were compared,Logistic regression analysis was used to screen the independent risk factors of hyperlip-idemia in T2DM patients.A nomogram prediction model was constructed based on the risk factors screened by Logistic regression analysis,the receiver operating characteristic(ROC)curve,calibration curve and decision curve were used to evaluate the predictive performance of the model.Results Compared with the T2DM group,the body mass index(BMI),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),apolipoprotein B(ApoB)/ApoA1,fasting blood glucose(FBG),glycated hemoglobin type A,c(HbA1c)and hypersensitive C-reactive protein(hs-CRP)levels in the T2DM combined with hyperlipidemia group significantly increased,while HDL-C level significantly de-creased,and the difference between the two groups were statistically significant(all P＜0.05).Logistic regression anal-ysis showed that TG,TC,LDL-C,HbA1c and hs-CRP were independent risk factors for hyperlipidemia in T2DM pa-tients(all P＜0.05).The nomogram model based on the above 5 indicators had good prediction performance,and the ROC area under the curve(AUC)was 0.82(95％CI:0.76-0.88);the calibration curve showed that the pre-dicted results of the model were in good agreement with the actual results(P=0.288);the decision curve showed that the model had a high net benefit value within a certain threshold probability.Conclusion TG,TC,LDL-C,HbA1c and hs-CRP are independent risk factors for hyperlipidemia in T2DM patients,the nomogram model constructed based on these indicators is of great value for the early prediction of hyperlipidemia in T2DM patients.

Abstract:Objective To investigate the assistant diagnostic value of 18F-fluorodeoxyglucose(18F-FDG)/positron emission tomography/computed tomography(PET/CT)for anemia by analyzing the correlation between 18F-FDG PET/CT multigroup parameters and hemoglobin concentration and the imaging characteristics of patients with anemia.Methods A total of 100 subjects who underwent 18F-FDG PET/CT examination in author's hospital from January to No-vember 2022 were selected and divided into anemia patients(anemia group,n=60)and non-anemia patients(control group,n=40)according to hemoglobin concentration,and the maximum standardized uptake value(SUVmax),mean standardized uptake value(SUVmean),left ventricular lumen and aortic lumen computed tomography(CT)values of bone marrow,liver and spleen were compared,the correlation between the above measurements and hemoglobin concen-tration and 18F-FDG PET/CT imaging characteristics of anemia patients were analyzed.Results The SUVmax and SU-Vmean of bone marrow,liver and spleen in the anemia group were higher than those in the control group,and the CT val-ues of left ventricular cavity and aortic cavity in the anemia group were lower than those in the control group,and the differences between the two groups were statistically significant(all P＜0.001);correlation analysis showed that the SUVmax and SUVmean of bone marrow,liver and spleen were negatively correlated with hemoglobin concentration(r=-0.289,-0.319,-0.343,-0.285,-0.406 and-0.373,respectively,all P＜0.05),the CT values of left ventricu-lar cavity and aortic cavity were positively correlated with hemoglobin concentration(r=0.754,0.514,all P＜0.001);among the 60 patients with anemia,there were 28 cases of ventricular septal hyperdensity sign,29 cases of aortic ring sign,10 cases of diffuse increased radioactivity in bone marrow and 11 cases of splenomegaly or diffuse increased radioac-tivity uptake in spleen.Conclusion Multimodal 18 F-FDG PET/CT imaging can provide new potential indicators and inno-vative research perspectives for the imaging diagnosis of anemia patient.

Abstract:Objective To investigate the mechanism of Dan Zhi Xiao Yao San Jia Wei intervening in primary hepatocellu-lar carcinoma by regulating phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/forkhead box(FOXO)signaling path-way.Methods A total of 5 SPF male SD rats aged 6 to 8 weeks were gavaged with 2 times Dan Zhi Xiao Yao San Jia Wei dosage(39.98 g/kg)according to the body surface area for 3 d,1 h after the last administration,blood was collected from the abdominal aorta,after centrifugation,the superna-tant was collected as drug-containing serum,filtered and ster-ilized for use.HepG2 hepatocellular carcinoma cells were ran-domly divided into control group and experimental group,HepG2 hepatocellular carcinoma cells in the experimental group were treated with serum containing 5％,10％,15％and 20％Dan Zhi Xiao Yao San Jia Wei,respectively,the control group(0％serum containing medicine)was routinely cultured.Proliferation inhibition rate was detected by cell counting kit-8(CCK-8);cell apoptosis rate and proliferation rate were detected by flow cytometry;scratch test was used to detect cell migration ability;Tran-swell assay was used to detect cell invasion ability;the expressions of PI3K,Akt and FOXO1 mRNA were detected by reverse transcription polymerase chain reaction(RT-PCR);Western blot was used to detect PI3K,Akt,FOXO1 and FOXO downstream apoptosis-related proteins B-cell lymphoma 2(Bcl-2)and Bcl-2 associated X protein(Bax)protein expressions.Results ① Com-pared with the control group,the OD of 10％,15％and 20％drug-containing serum in the experimental groups decreased,the cell proliferation inhibition rate increased(all P＜0.01);in the experimental group,with the increase of drug-containing serum concentration,OD decreased gradually,and cell proliferation inhibition rate increased significantly(all P＜0.05).② Compared with the control group,the apoptosis rate of cells in the experimental groups with 10％,15％and 20％drug-containing serum increased,and the cells proliferation rate,migration distance,invasive number of cells and the invasive number of cells in the ex-perimental groups with 5％drug-containing serum decreased(all P＜0.05);in the experimental group,with the increase of drug-containing serum concentration,the apoptosis rate increased,and the cell proliferation rate,migration distance and invasion number decreased(all P＜0.05).③ Compared with the control group,the expression levels of PI3K,Akt and FOXO1 mRNA in the experimental group decreased,and the differences were statistically significant(all P＜0.05),except for Akt mRNA level in 5％drug-containing serum(P＞0.05);in the experimental group,with the increase of drug-containing serum concentration,the inhibition trend was gradually significant.④ Compared with the control group,the levels of PI3K,Akt,FOXO1 and Bcl-2 protein in the experimental group decreased,and the level of Bax protein increased(all P＜0.01),except for the level of FOXO1 protein in the 5％drug-containing serum(P＞0.05);with the increase of drug-containing serum concentration,the trend was more significant.Conclusion Dan Zhi Xiao Yao San Jia Wei can significantly inhibit the proliferation,migration and invasion of HepG2 hepatocellular carcinoma cells,induce cell apoptosis,and its mechanism may be related to the regulation of PI3K/Akt/FOXO signaling pathway.

Abstract:Objective To explore canopy fibroblast growth factor signaling regulator 2(CNPY2)and myosin regu-latory light chain interacting protein(MYLIP)expressions in cervical cancer tissues and their correlations with clinico-pathological characteristics,microvessel density(MVD)and prognosis.Methods Data of 93 cervical cancer patients who admitted to author's hospital from February 2017 to January 2021 were selected.Reverse transcription-quantitative poly-merase chain reaction(RT-qPCR)was used to detect CNPY2 and MYLIP mRNA levels in cervical cancer tissues.Immu-nohistochemical methods was used to detect MVD in cervical cancer tissues.Pearson correlation analysis was used to ana-lyze the correlation between CNPY2,MYLIP mRNA expression levels and MVD.The relationship between CNPY2,MYLIP mRNA and clinical pathological features were analyzed.The patients were followed up for 3 years,and the sur-vival curve was drawn by Kaplan-Meier method to analyze the prognosis.Receiver operating characteristic(ROC)curve was used to analyze the predictive value.Results The expression levels of CNPY2,MYLIP mRNA and MVD in cervical cancer tissues were higher than those in adjacent tissues(all P＜0.001).The expression levels of CNPY2 and MYLIP mRNA in cervical cancer tissues were posi-tively correlated with MVD(r=0.736,0.635,all P＜0.001).The expressions of CNPY2 and MYLIP mRNA in cervi-cal cancer tissues with undifferentiated or poorly differentiated stages,federation international of gynecology and obstet-rics(FIGO)stage Ⅲ-Ⅳ,infiltration depth≥ 1/2,lymph node metastasis and distant metastasis were higher(all P＜0.001).The 3-year overall survival(OS)and recurrence free survival rate(RFS)of patients with high CNPY2 levels were 59.57％and 55.32％,respectively,which were lower than the 86.96％and 80.43％of the patients with low CNPY2 levels(all P＜0.05).The 3-year OS and RFS of the patients with high MYLIP levels were 60.00％and 53.33％,respectively,which were lower than the 85.42％and 81.25％of the patients with low MYLIP levels(all P＜0.05).The areas under the curve for predicting poor prognosis in cervical cancer patients using CNPY2,MYLIP mRNA and their combined detection were 0.880,0.856 and 0.951,respectively.Conclusion CNPY2 and MYLIP are highly ex-pressed in cervical cancer tissues,the mRNA expressions are positively correlated with MVD,which are closely related to degree of differentiation,FIGO stage,depth of infiltration,lymph node metastasis,distant metastasis and prognosis.

Abstract:Objective To investigate the monitoring role of high-frequency ultrasound in the changes of eye struc-ture and hemodynamic parameters in individuals rapidly ascending to plateau.Methods The eye grayscale and doppler ul-trasound images were collected from 70 healthy individuals from the plains including axial length,transverse ocular diame-ter,anterior chamber depth,lens thickness,optic nerve sheath diameter and blood flow parameters of posterior ciliary ar-tery,central retinal artery and ophthalmic artery before ascending to high altitudes,after 1 week of rapid ascent and after 1 year of residing at plateau.Results Compared with those before ascending to plateau,axial length,transverse ocular diameter and optic nerve sheath diameter of the subjects who rapidly ascending to plateau for 1 week increased,the peak systolic velocity(PSV)of posterior ciliary artery,central retinal artery and ophthalmic artery decreased,and the resist-ance index(RI)increased(all P＜0.05);compared with those who rapidly ascending to plateau for 1 week,axial length,transverse ocular diameter and optic nerve sheath diameter of the subjects who rapidly ascending to plateau for 1 year de-creased,the PSV of the posterior ciliary artery,central retinal artery and ophthalmic artery increased,and the RI de-creased(all P＜0.05);there was no significant difference in the eyeball structure and hemodynamics of the subjects 1 year after rapidly ascending to high altitudes compared with those before rapidly ascending to plateau(all P＞0.05).Con-clusion Rapidly ascending to plateau will change the ocular structure and arterial blood flow of plain people,and gradual-ly return to the level before rapidly ascending to plateau after living for a period of time.High-frequency ultrasound can dynamically monitor the change process and provide reference for ensuring the eye health of people stationed at plateau.

Abstract:Objective To investigate the impacts of remifentanil on hemodynamics and memory function in mice with hem-orrhagic shock resuscitation(HSR)through the thioredoxin interacting protein(TXNIP)/nucleotide binding oligomerization do-main like receptor protein 3(NLRP3)/cysteinyl aspartate specific proteinase1(Caspase-1)signaling pathway.Methods A total of 72 C57BL/6 male mice were randomly divided into sham operation group(inject an equal amount of normal saline into the tail vein),model group(inject an equal amount of normal saline into the tail vein),remifentanil low-dose group(tail vein injection of 4 mg/kg remifentanil+equal amount of normal saline),remifentanil high-dose group(tail vein injection of 8 mg/kg remifentanil+equal amount of normal saline),remifentanil high-dose+empty lentivirus(pLVX-NC)group(tail vein injection of 8 mg/kg remifentanil+2.5 μl pLVX-NC)and remifentanil high-dose+TXNIP overexpression lentivirus(pLVX-TXNIP)group(tail vein injection of 8 mg/kg remifentanil+2.5 μl pLVX-TXNIP)with 12 mice in each,according to the random number table method.The mice in the sham operation group were only punctured without exsanguination,and HSR models were estab-lished in all groups except the sham operation group.The learning and memory functions of mice were tested by water maze;the mean arterial pressure(MAP),heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP)of mice in each group were measured by color Doppler ultrasound;cell apoptosis were detected by terminal deoxynucel neotidyl transferas-media-ted dUTP nick end labeling(TUNEL)method;the content of malondialdehyde(MDA),activities of superoxide dismutase(SOD)and catalase(CAT)in mice hippocampal tissues were detected by colorimetry;the expression of TXNIP/NLRP3/Caspase-1 pathway proteins were detected by Western blot.Results Compared with the sham operation group,the escape laten-cy,apoptotic cell positivity rate,MDA content,TXNIP,NLRP3 and Caspase-1 protein expressions of mice in model group sig-nificantly increased(all P＜0.05);times of passed through the original platform,MAP,HR,DBP,SBP and the activities of SOD and CAT significantly decreased(all P＜0.05).Compared with the model group,the escape latency,apoptotic cell positivi-ty rate,MDA content,TXNIP,NLRP3 and Caspase-1 protein expressions of mice significantly decreased in remifentanil low-dose and high-dose groups(all P＜0.05);times of passed through the original platform,MAP,HR,DBP,SBP and the activi-ties of SOD and CAT significantly increased(all P＜0.05).Compared with the low-dose remifentanil group,the escape latency,apoptotic cell positivity rate,MDA content,TXNIP,NLRP3 and Caspase-1 protein expressions of mice in remifentanil high-dose group significantly decreased(all P＜0.05);times of passed through the original platform,MAP,HR,DBP,SBP and the ac-tivities of SOD and CAT of mice significantly increased(all P＜0.05).Compared with the remifentanil high-dose and remifentanil high-dose+pLVX-NC group,the escape latency,apoptotic cell positivity rate,MDA content,TXNIP,NLRP3 and Caspase-1 protein expressions of mice in remifentanil high-dose+pLVX-TXNIP group significantly increased(all P＜0.05);times of pas-sed through the original platform,MAP,HR,DBP,SBP and the activities of SOD and CAT of mice significantly decreased(all P＜0.05).Conclusion Remifentanil may promote hemodynamic stability and memory function improvement in HSR mice by inhibiting TXNIP/NLRP3/Caspase-1 signaling pathway.

Abstract:Objective To investigate the coping status of casualty flow saturation impact of surgical teams in field medical stations,so as to provide reference for developing casualty transfer plans.Methods A total of 15 military hospi-tals from 12 cities were selected using convenience sampling method from July 1 to 30,2023,and personnel of field medi-cal stations were chosen as research subjects in accordance with the inclusion and exclusion criteria.The questionnaire was developed through literature review,medical data consulting,multiple rounds of expert consultation and pre-survey verifi-cation,and 23 items in 3 dimensions,including the current allocation of personnel,materials and equipment,the current situation and resistance of perioperative transfer of wounded(preoperative preparation,intraoperative connection,postop-erative transfer),and macro problems of transfer efficiency.Results A total of 155 personnel from field medical station(medical personnel and support personnel)from 15 hospitals in 12 cities were included in this study,and the effective re-covery rate of the questionnaire was 100％.In terms of the current allocation of personnel,materials and equipment in the surgical teams,75 field medical team personnel believed that the best ratio of doctors to nurses in the surgical teams was 1∶2,and the main reason for the lack of surgical materials was insufficient personnel(30.97％).In terms of the current situation and resistance of perioperative wounded transfer,during preoperative preparation,9.03％of the field medical team members still believed that it was nec-essary to wait 20-30 min for the severely wounded to prepare the tent.The main reasons for surgical materials not meeting the needs were poor circulation of the operat-ing table(45.81％)and insufficient personnel in the treatment of the wounded(67.10％);during the intraoperative con-nection,difficulties in central venipuncture or tracheal intubation(50.97％)and delay in transferring wounds(45.16％)were the main reasons for intraoperative circulation obstacles and affecting the normal connection of consecutive opera-tions,the main problem of nursing staff in the surgical teams was too long time of transferring wounded(51.61％);dur-ing postoperative transfer,the key link to shorten the postoperative transport time was the allocation of transport person-nel(71.61％),and the reasonable way of postoperative transport was the combination of anterior transfer and posterior transfer(67.10％).In terms of the macro problems of the transfer efficiency of the wounded,the main problems affect-ing the transfer of the wounded were the unclear strategy of the transfer of the wounded to other departments and the in-adequate handovers(67.74％),the core technology of the surgical teams when facing the saturation impact of the woun-ded flow was mainly the dynamic positioning of the wounded(78.71％).Conclusion There are multiple layers of obsta-cles in the circulation of the wounded when the flow of the wounded is saturated,it is suggested to optimize the allocation of human,materials and equipment resources,solve the main pain points and blocking points of the perioperative circula-tion of the wounded,improve the teamwork ability,clarify the strategy of the circulation of the wounded and the dynamic positioning of the personnel,alleviate the backlog of the surgical wounded and complete the task of medical security effi-ciently;at the same time,it provides theoretical support for the operation of nursing staff in the surgical teams of the field medical institute in the future.

Abstract:Objective To investigate the demands of plateau officers and soldiers for psychological services and their attitudes towards seeking professional psychological help,so as to provide a basis for targeted psychological serv-ices.Methods The attitudes toward seeking professional psychological help scale-short form(ATSPPH-SF)and a self-developed psychological health education and service needs questionnaire were used to conduct the questionnaire survey among 1 484 officers and soldiers at plateau.Results The requirement for psychological services was indicated by 34.97％of the officers and soldiers,and it was found that 93.73％of officers and soldiers exhibited an understanding of psychological knowledge,the most preferred method of psychological service was found to be mental health education lec-tures(70.82％),and the most needed content was identified as the popularization of psychological knowledge(73.11％).The contents of psychological health education that were found to be the most interesting to the officers and soldiers were as follows:basic knowledge and skills of emotional self-regulation(72.71％),interpersonal communication skills(69.74％),self-improvement(54.58％)and how to cope with stress and setbacks(52.22％).The mean total score of ATSPPH-SF of officers and soldiers at plateau was(15.43±3.81),significant effects on the total ATSPPH-SF scores were observed in relation to different identities,work experience,marital status and whether they were only children.Conclusion Although the officers and soldiers at plateau may be confronted with more psychological problems,their will-ingness to actively seek psychological help remains weak,it is necessary to carry out work according to the characteristics of their psychological service needs to promote their positive attitudes to seek professional psychological help.

Abstract:Objective To construct the medical system of future battlefield of Chinese army based on the guideline of tactical combat casualty care(TCCC)(2024 version),so as to provide reference for the theory,practice and technical development of war casualty care in China.Methods Through literature review and public reports,combined with the latest revision of the TCCC guidelines(2024 version),the technical innovation,multidisciplinary collaboration mode and intelligent application progress of TCCC were systematically reviewed,and the future development priorities of TCCC in Chinese Army were put forward based on actual combat requirements.Results The innovation of TCCC,such as stand-ardized process,hemostatic technology optimization and virtual reality training technology,was reshaping the TCCC sys-tem.Conclusion The Chinese army can improve its battlefield treatment ability through the technical update of TCCC,the transformation of treatment mode and the future development focus of Chinese army.

Abstract:Objective To explore the effect and mechanism of methacrylated gelatin(GelMA)hydrogel loaded with mice placental derived mesenchymal stem cells(PDMSCs)in promoting wound healing in diabetic mellitus mice.Methods PDMSCs-GelMA hydrogel was prepared by light curing method,the microstructure of PDMSCs-GelMA hydrogel was observed through scanning electron microscope,5-e-thynyl-2-deoxyuridine5(EdU)was used to detect the cell proliferation of PDMSCs in hydrogel;live-dead cell stai-ning was used to detect the cell survival rate of PDMSCs in hydrogel;the expressions of epidermal growth factor(EGF)and vascular endothelial growth factor(VEGF)of leach liquor in PDMSCs-GelMA hydrogel was detected by en-zyme-linked immunosorbent assay(ELISA),the cultured PDMSCs were divided into hydrogel group and non-hydrogel group,hydrogel extract group and non-hydrogel extract group depending on whether it contained hydrogel or not.The full-thickness skin injury model was established on the back of mice by using hole punch,and the mice were divided into phosphate buffered saline(PBS)group,PDMSCs group and PDMSCs-GelMA group,with 9 mice in each,the mice in each group was treated with equal volumes of PBS,PDMSCs and PDMSCs-GelMA respectively,the healing of the back wound of mice was observed on the 1st,7th and 14th days of the treatment,hematoxylin-eosin(HE)staining and Mas-son staining were used to detect the collagen tissue in the epidermis and dermis of the wound skin tissue at the 7th day,immunohistochemistry staining was used to detect epidermal stem cells,neovascularization and inflammation in the skin wound at the 7th day.Results PDMSCs-GelMA hydrogel was successfully prepared,scanning electron microscopy ob-served that PDMSCs-GelMA exhibited highly porous and interconnected internal structure and the cells grew well and full of pores.EdU assay confirmed that the proliferation rate of PDMSCs with hydrogel was significantly higher than that in non-hydrogel group(P＜0.05).Live-dead cell staining showed that cytoactive of PDMSCs in hydrogel group was slight-ly higher than that in the non-hydrogel group,but there was no statistically significant difference between the two groups(P＞0.05).ELISA results showed that on the 3rd and 7th days of the culture,the concentrations of EGF and VFGF in the hydrogel extract group were lower than those in the non-hydrogel extract group(all P＜0.05).Compared with the PBS group,the wound healing rate of mice in PDMSCs group and PDMSCs-GelMA group increased(all P＜0.05);com-pared with PDMSCs group,the wound healing rate of PDMSCs-GelMA group significantly increased(P＜0.05).The re-sults of HE staining and Masson staining showed that the new granulation tissue and collagen deposition rate in PDMSCs-GelMA group were significantly higher than those in PBS group and PDMSCs group.On the 7th day after operation,compared with PBS group,the positive numbers of Brdu and CD1 1 b in PDMSCs group and PDMSCs-GelMA group in-creased,and the expression of PDMSCs-GelMA group was higher than that of PDMSCs group(all P＜0.05);the CD45 positive number decreased,and the number of PDMSCs-GelMA group was lower than those of PDMSCs group(all P＜0.05).Conclusion PDMSCs-GelMA hydrogel has good permeability of nutrients,PDMSCs-GelMA hydrogel promotes diabetic mellitus wound healing by promoting granulation tissue proliferation,neovascularization and epithelialization,while reducing inflammatory response.

Abstract:Objective To explore the predictive value of peripheral blood inflammatory markers and its nomogram model for postoperative central diabetes insipidus(CDI)in patients with craniopharyngioma.Methods The clinical data of 239 patients with craniopharyngioma admitted to author's hospital from January 2018 to December 2023 were collected.According to the pres-ence or absence of CDI,the patients were divided into CDI occurrence group(n=88)and CDI non-occurrence group(n=151).The clinical data of the two groups were compared,Logistic regression model was used to analyze the influencing factors of CDI in patients with craniopharyngioma after surgery,and the nomogram model was constructed;receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate the predictive value of peripheral blood inflammatory indi-cators and nomogram model for postoperative CDI in patients with craniopharyngioma.Results In the CDI occurrence group,the surgical procedure was transsphenoidal endoscopic resection,the resection range was total resection,the propor-tion of patients with the history of diabetes mellitus,and the inflammatory markers of white blood cell(WBC),neutrophil(NEUT),neutrophil/lymphocyte(NLR),C reactive protein(CRP)and C reactive protein/albumin(CAR)were significantly higher in the CDI non-occurrence group,while the inflammatory markers lymphocyte(LY)and monocytes/lymphocyte(MLR)in CDI occurrence group were significantly lower than that in CDI non-occurrence group(all P＜0.05).Multivariate Logistic re-gression analysis showed that total resection,WBC,NEUT and CAR were independent risk factors for CDI in patients with cra-niopharyngioma(all P＜0.05).the area under the curve(AUC)of the model was 0.963(95％CI:0.940-0.987);the sensi-tivity was 0.890,the specificity was 0.954 and the Youden index was 0.844;the AUC of NEUT was 0.950(95％CI:0.922-0.978).The curve of the nomogram model based on total resection,WBC,NEUT,CAR and the NEUT level curve were above the curves of the total intervention and non-intervention models,which could obtain better net benefits.Conclusion The nomo-gram model and NEUT level can well predict the probability of postoperative CDI.

Abstract:Objective To explore the changes of end-tidal carbon dioxide tension(PETCO2)level after cardiopulmonary re-suscitation and its relationship with prognosis in patients with cardiac arrest.Methods A retrospective analysis was performed on the clinical data of 107 patients with cardiac arrest in author's hospital from May 2018 to May 2023,PETCO2 was continuously monitored by electrocardiographic monitoring at different timing,according to the return of spontaneous circulation(ROSC),those who recovered from ROSC after cardiopulmonary resuscitation were included in the ROSC group(n=38)and those who did not were included in the non-ROSC group(n=69),according to the survival status of patients at 24 h after cardiopulmonary re-suscitation,the patients in the ROSC group were divided into survival group(n=22)and death group(n=16).The general data of patients in ROSC group and non-ROSC group were compared;Logistic regression was used to analyze the influencing factors of ROSC in patients with cardiac arrest and cardiopulmonary resuscitation;PETCO2 levels were compared between ROSC group and non-ROSC group at 0,5,10 and 20 min after resuscitation,receiver operating characteristic(ROC)curve was used to analyze the predictive value of PETCO2 level at each timing for the prognosis of patients;PETCO2 level at 6 h after resuscitation was compared between the survival group and the death group,the ROC curve was used to analyze the predictive val-ue of PETCO2 level at 6 h after resuscitation for the death of patients within 24 h.Results ① The proportions of patients with cardiogenic cardiac arrest and non-defibrillation heart rhythm in non-ROSC group were higher than those in ROSC group,while the proportion of PETCO2 level＞18 mmHg was lower than that in ROSC group(all P＜0.05).② The results of Logistic regression analysis showed that cardiogenic cardiac arrest,non-defibril-lation heart rhythm and low level of PETCO2 were independent risk factors of ROSC.③ In the non-ROSC group,the PETCO2 lev-el of patients was first increased and then decreased with the extension of resuscitation time,reached the peak at 5 min of resusci-tation,and then continued to decrease,and the differences at different timing were statistically significant(all P＜0.05);in ROSC group,the level of PETCO2 increased gradually with the extension of resuscitation time,and the differences at different timing were statistically significant(all P＜0.05);compared with the non-ROSC group,the PETCO2 level increased at each tim-ing in the ROSC group(all P＜0.05).④ The ROC area under the curve(AUC)of PETCO2levels at 0,5,10 and 20 min after resuscitation for predicting ROSC were 0.682,0.777,0.804 and 0.928,respectively.⑤ PETCO2 level at 6 h after resuscitation was higher in the survival group than in the death group(P＜0.05).AUC of PETCO2 level at 6 h after successful resuscitation in ROSC patients for predicting death within 24 h was 0.807(95％CI:0.658-0.956),the sensitivity was 81.25％and the spe-cificity was 86.36％.Conclusion Monitoring the change of PETCO2 in patients with cardiac arrest during cardiopulmonary resus-citation shows that PETCO2 is related to the prognosis of patients,PETCO2 can be used as an evaluation index for the effectiveness of resuscitation and early prognosis of resuscitation.

Abstract:Objective To explore the therapeutic effect of Apatinib combined with interferon-γ on gastric cancer and its possible mechanism.Methods Taking the human gastric cancer cell line MGC803 as the research objects,the ob-jects were randomly divided into the control group[only given the same amount of 1％dimethyl sulfoxide(DMSO)],Ap-atinib group(intervened with Apatinib at 8 μmol/L),interferon-γ group(intervened with interferon-γ at 100 U/ml),Ap-atinib+interferon-γ group(after pretreatment with interferon-γ at 100 U/ml for 24 h,8 μmol/L Apatinib was added)and Apatinib+interferon-γ+ferrostatin-1(Fer-1)group(after pretreatment with interferon-γ 100 U/ml for 24 h,Ap-atinib 8 μmol/L and Fer-1 1 μmol/L was added),subsequent experiments were performed 72 h later.Cell migration and invasion were detected by the Transwell assay,the amount of lactatedehydrogenase(LDH)released from cells,malondi-aldehyde and reduced glutathione(GSH)contents were detected by kits,intracellular Fe2+content was detected by Ferro Orange probe;mitochondrial structure was detected by transmission electron microscopy;mitochondrial membrane poten-tial was detected by JC-1 staining;the levels of mitochondrial DNA(mtDNA)and cytoplasmic dsDNA(cDNA)in cells were detected by reverse transcription polymerase chain reaction(RT-PCR).A tumor-bearing mouse model of gastric cancer was constructed,and they were randomly divided into control group,interferon-γ group[interferon-γ 1.5 U/(kg·d)intraperitoneally inj ected],Apatinib group[Apatinib 200 mg/(kg·d)by gavage]and Apatinib+interferon-γ group[interferon-γ 1.5 U/(kg·d)intraperitoneally injected and Apatinib 200 mg/(kg·d)by gavage simultaneously],all groups were treated for 20 d,with 5 mice in each.Immunofluorescence staining was used to detect the expression of Mi-toSOX-Red in cancer cells and the stimulator of interferon genes(STING)and golgi matrix protein 130(GM130)co-lo-calization in cancer tissues;protein expressions of human prostaglandin-endoperoxide synthase 2(PTGS2),solute carrier family 7 member 1 1(SLC7A11)and glutathione peroxidase4(GPX4)and cancer tissues p-STING,STING,phosphoryla-ted-TANK-binding kinase 1(p-TBK1)and phosphorylated-interferon regulatory factor 3(p-IRF3)were detected by Western blot;the levels of reactive oxygen species and lipid reactive oxygen species in cells and the proportion of immune cells were detected by flow cytometry.Results Compared with Apatinib group,the cell survival rate of Apatinib+in-terferon-γ group reduced,when the concentration of Apatinib was 8 μmol/L,the combined treatment with interferon-γachieved an effective inhibitory concentration.Compared with the MGC803 cells in the control group,the leakage of LDH in the Apatinib group increased,the number of invasive cells and migratory cells decreased,the levels of Fe2+,reactive oxygen species,lipid reactive oxygen species and malondialdehyde and the expression of PTGS2 increased,the content of GSH and the expressions of SLC7A11 and GPX4 decreased,and mitochondrial breaks and crists were absent,the fluores-cence intensity ratio of J-aggregate/Monomers and mtDNA level decreased,the relative fluorescence intensity and cDNA level of MitoSOX-Red increased,and the mtDNA level decreased(all P＜0.05).Compared with the Apatinib group,the leakage of LDH in MGC803 cells in the Apatinib+interferon-γ group increased,the number of invasive cells and migra-tory cells decreased,the levels of Fe2+,reactive oxygen species,lipid reactive oxygen species and malondialdehyde and the expression of PTGS2 increased,the content of GSH and the expressions of SLC7A11 and GPX4 decreased,and mito-chondrial breaks and crists were absent,the fluorescence intensity ratio of J-aggregate/Monomers and the level of mtDNA also decreased,and the relative fluorescence intensity of MitoSOX-Red and cDNA level also increased(all P＜0.05).A tumor-bearing mouse model of gastric cancer was constructed,compared with the control group,the tumor volume and weight of mice in the Apatinib group decreased,the co-localization fluorescence intensity of STING and cis-GM130 in tumor tissues and the expressions of p-STING,p-TBK1 and p-IRF3 increased,the proportions of DC,CD8+T cells and central memory T cells increased,the proportion of exhausted T cells decreased(all P＜0.05);compared with the Apa-tinib group,the tumor volume and weight of mice in the Apatinib+interferon-γ group both decreased,the co-localization fluorescence intensity of STING and cis-GM130 in tumor tissues and the expressions of p-STING,p-TBK1 and p-IRF3 in-creased,the proportions of DC,CD8+T cells and central memory T cells increased,the proportion of exhausted T cells decreased(all P＜0.05).Conclusion Interferon-γ combined with Apatinib treatment may promote mtDNA release in-duced by ferroptosis-related mitochondrial stress and initiate the cyclic guanosine monophosphate adenylate synthetase(cGAS)-STING pathway,improve the tumor microenvironment,promote anti-tumor immune responses and enhance the sensitivity of gastric cancer cells to Apatinib.